The current way of life in industrialised countries may be characterised by less physical work and increased consumption of fat and carbohydrates, resulting in the energy intake exceeding energy expenditure. This shift in the energy balance causes storage of energy in the body in form of fat, leading to an increase of overweight and obesity, due to the long-term energy imbalance associated with lifestyle.
The percentage of overweight people increases year by year and obesity is a disease that is reaching epidemic proportions in some countries. The health risks associated with overweight and obesity are numerous and it has been shown that these conditions contribute to morbidity and mortality of individuals suffering from diseases such as hypertension, stroke, diabetes mellitus type II, gallbladder disease and ischaemic heart disease. The cosmetic perspective of body fat is also to be considered as the demand for dietary supplements or medicine to gain or maintain a leaner body is constantly increasing.
A common strategy for reducing the risk of overweight and obesity has been to reduce the average energy intake by lowering the dietary fat intake. Dietary fat is a major determinant for energy density of the diet and thereby for energy intake. A reduction in the daily consumption of fat concurrently, with an increase in the consumption of foods rich in complex carbohydrates, is part of the dietary recommendations in many countries.
An additional strategy may be to consume foods with a low digestibility. It is well established that the dietary fibre content of the diet is an important determinant of the digestibility of energy and energy-contributing macro-nutrients. It has been suggested that increasing amounts of dietary fibres in the food promotes satiety and thereby reduces energy intake, and decreases transit time of ingested food in the intestinal tract.
Another strategy for weight management is to reduce fat absorption from the gastrointestinal tract by using various kinds of medicaments. Fat is mainly consumed in the form of triglycerides and pancreatic lipases are required to break down the triglycerides into monoglycerides and fatty acids in order for the body to absorb the fat from the gastrointestinal tract. U.S. Pat. No. 4,598,089 disclose the compounds lipstatin and tetrahydrolipstatin, which reduce fat absorption by inhibiting pancreatic lipase. WO9933450 discloses the weight loss effect of sibutramine and orlistat, where sibutramine promotes decreased food intake by enhancing satiety and orlistat inhibits lipases from breaking down ingested fat. U.S. Pat. No. 5,643,874 discloses a composition comprising both glucosidase/amylase inhibitors such as acarbose or voglibose and lipase inhibitors such as orlistat or lipstatin for treatment of obesity. However, in view of the complexity of the genetic component of obesity and the various psychological factors involved in maintaining lifestyle habits, the long term efficacy of such medicaments in managing body weight and decreasing obesity-related medical complications is unknown.